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  • Appendicitis  (5)
  • Associated anomalies  (1)
  • Electron-microscopy  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Appendiceal mass in children (1995)
    Springer
    Pediatric surgery international 10 (1995), S. 79-81 
    Details
    ISSN: 1437-9813
    Keywords: Appendiceal mass ; Appendicitis ; Child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 198 were diagnosed to have an appendiceal mass between 1982 and 1991;9 underwent appendicectomy immediately following diagnosis. One developed a wound infection. Of the remaining 189 patients 162 (85.7%) had unevenful resolution of the mass. The mean duration of hospital stay was 9.7 days. Twenty-seven patients failed to respond to initial non-operative management; 16 developed an appendix abscedd and required drainage. One patient had percutaneous drainage under ultrasound control. One of these 16 patients developed a wound infection after interval appendicectomy. Four other patients underwent appendicectomy during the initial admission because of clinical deterioration and all of them were found to have an appendix mass at operation. Three of these 4 patients developed postoperative complications (wound infection 1, intra-abdominal abscess 1, small-bowel obstruction 1). Seven other patients required admission and appendicectomy while waiting for interval appendicectomy. At operation, 5 still had an appendiceal mass/ abscess and 2 had acute appendicitis. The child with an appendiceal abscess continued to have a discharging wound for 19 days. All others, except 3 patients who were lost to follow-up, underwent interval appendicectomy. Mean duration of hospital stay for interval appendicectomy was 301 days. Two patients who did not return for elective appendicectomy developed acute appendicitis and required appendicectomy 65 days and 8 months after discharge. Three (1.9%) of 161 patients (all in the first half of the series) developed postoperative complications following interval appendicectomy (wound hematoma 1, wound infection 1. pneumonia 1). Evidence of inflammation was present on histological examination in 47.2% of the cases. These data support the belief that initial non-operative management of an appendiceal mass followed by interval appendicectomy is a safe and effective method of management.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00171159
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  • 2
    Electronic Resource
    Electronic Resource
    Appendicitis diagnosed following active observation does not increase morbidity in children (1995)
    Springer
    Pediatric surgery international 10 (1995), S. 76-78 
    Details
    ISSN: 1437-9813
    Keywords: Appendicitis ; Active observation ; Child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An audit was undertaken to assess the outcome of patients aged less than 16 years who underwent appendicectomy after active obsevation. A comparison was made of the incidence of perforation, complications, and hospital stay of patients who underwent emergency appendicectomy (group A) and those who were operated upon after active observation (group B). A total of 1,672 patients were admitted with acute abdominal pain. Emergency appendicectomy following the diagnosis of acute appendicitis on admission was performed in 744 patients (group A); an appendicectomy was performed in 123 patients following active observation (group B). In group A, 140 patients (18.8%) were found to have macroscopic or microscopic perforations; a normal appendix was removed in 75 (10.1%) cases and 31 (4.2%) patients developed postoperative complications. In group B, perforations occurred in 19 (15.1%) patients, normal appendix was encountered in 25 (19.8%), and postoperative complications occured in 7 (5.5%). The overall normal appendicectomy rate was 11.5%. Mean duration of hospital stay was 3.5 days in group A and 4.7 days in group B. The remaining patients who were actively observed and did not require surgery were discharged when their symptoms and signs had resolved. The study illustrates that appendicectomy after a period of active observation in hospital fro acute abdominal pain carries no increase in morbidity compared with urgent appendicectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00171158
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Ultrastructural demonstration of abnormal multiaxonal Schwann-cell units in Hirschsprung's disease (1989)
    Springer
    Pediatric surgery international 4 (1989), S. 326-331 
    Details
    ISSN: 1437-9813
    Keywords: Hirschsprung's disease ; Electron-microscopy ; Schwann cells ; Monoclonal antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pathophysiology of Hirschsprung's disease is not fully understood. Using light microscopy we have previously demonstrated the absence of a unique Schwann-cell antigen in the circular muscle of aganglionic colon identified by D7 monoclonal antibody. In an attempt to characterise the morphological changes in neuronal cells at subcellular level, we studied innervation patterns in normal and aganglionic colon by electron microscopy. The most striking observation on ultrastructural serial examination of the entire resected specimen of colon from patients with Hirschsprung's disease was the presence of grossly swollen monoaxonal or oligoaxonal Schwann cell units with loss of cellular contents in the circular muscle of aganglionic colon. The extent of subcellular changes in Schwann cells and axons corresponded with a diminution of immunoreactivity with a panel of neuronal cell antibodies. These ultrastructural findings suggest that degenerative changes in Schwann cells and axons within the circular muscle coat of aganglionic segment may be a significant factor in the pathogenesis of Hirschsprung's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00183400
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  • 4
    Electronic Resource
    Electronic Resource
    Neonatal perforated appendicitis associated with duodenal obstruction (1992)
    Springer
    Pediatric surgery international 7 (1992), S. 306-307 
    Details
    ISSN: 1437-9813
    Keywords: Appendicitis ; Duodenal obstruction ; Newborn
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case of a premature infant with a simultaneous occurrence of appendiceal perforation and incomplete fixation of the colon producing early obstruction of the duodenum is reported. The clinical examination and laboratory and radiological investigations were all negative for the diagnosis of appendicitis, which was found incidentally at laparotomy for duodenal obstruction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00183990
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  • 5
    Electronic Resource
    Electronic Resource
    Appendicitis in preschool children (1995)
    Springer
    Pediatric surgery international 10 (1995), S. 68-70 
    Details
    ISSN: 1437-9813
    Keywords: Appendicitis ; Preschool child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Appendicitis in preschool children, although uncommon, is associated with a high perforation rate and increased morbidity. Of 132 preschool children treated for appendicitis over a 5-year period, 63 (47.7%) had perforations and 29 (22.0%) had an appendiceal mass. Although classic symptoms were present in the majority of the patients, atypical symptoms were found in many children and included diarrhoea (35), cough/sore throat (15), dysuria (4), headache (2), and earache (2). A diagnosis other than appendicitis was suspected by attending medical practitioners in 53 (40%) patients, leading to delay in management. Mean duration of symptoms before admission was as follows: acute appendicitis 38.9 h, perforation 52.6 h, and appendix mass 81.7 h. Ten (7.6%) patients developed postoperative complications that included wound infection in 5, intra-abdominal abscess in 4, and adhesive intestinal obstruction in 1. A high index of suspicion of appendicitis is necessary in preschool children in view of the atypical presentation and high incidence of advanced appendicitis and morbidity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00171156
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  • 6
    Electronic Resource
    Electronic Resource
    Natural history of congenital diaphragmatic hernia: implications for management (1987)
    Springer
    Pediatric surgery international 2 (1987), S. 327-330 
    Details
    ISSN: 1437-9813
    Keywords: Congenital diaphragmatic hernia ; Incidence ; Mortality ; Associated anomalies ; Prenatal correction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Advances in ultrasonography have made it possible to accurately diagnose congenital diaphragmatic hernia (CDH) prenatally, and recently interest has been expressed in in-utero correction of CDH as a solution to the problem of high mortality. In an attempt to elucidate the natural history of CDH, we analysed the incidence and mortality of this disorder in a large maternity hospital with an autopsy rate of 100% for all stillbirths and neonatal deaths. Between 1973 and 1985, there were 47 cases of CDH among 99,062 births, an incidence of 1 in 2,107 birhts. There were 15 (32%) stillbirths and 32 (68%) live births. All 15 stillborns had lethal associated non-pulmonary anomalies. Of the 32 liveborn patients, 17 died prior to transfer to the referral centre and 11 of these had major associated anomalies. Prematurity was a feature in 65% of patients who died prior to transfer to the referral centre. Nine of the 15 patients who arrived at the referral centre survived. Our date suggest that the only patient who may benefit from prenatal correction of CDH is a fetus who has serious persistent pulmonary hypertension. However, in the absence of reliable criteria for the in-utero prediction of persistent pulmonary hypertension in association with CDH, surgical correction of CDH prenatally is not practicable at present even for this group of patients. Newer therapeutic approaches in the management of persistent pulmonary hypertension should be addressed as the most promising approach in the management of a CDH patient who develops respiratory failure in the first few hours of life.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00175643
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  • 7
    Electronic Resource
    Electronic Resource
    Management of appendiceal mass in children (1989)
    Springer
    Pediatric surgery international 4 (1989), S. 306-308 
    Details
    ISSN: 1437-9813
    Keywords: Appendiceal mass ; Appendicitis ; Conservative treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During a 5-year period 1072 children were treated for appendicitis. Of these, 112 (10.5%) had an appendiceal mass at presentation that was discovered in 32 cases on clinical examination, in 3 on ultrasound, and in 77 (69%) on examination under anaesthesia. All patients were treated conservatively initially; 98 (87.5%) had uneventful resolution of the appendiceal mass and were discharged after a mean hospital stay of 10.5 days. Fourteen (12.5%) failed to respond to conservative management: 10 showed worsening of symptoms during hospitalisation and required drainage of an appendiceal abscess and 4 were readmitted with recurrence of symptoms 2, 4, 4, and 11 days respectively following discharge. These were managed by appendicectomy. Interval appendicectomy was performed after a mean 6.8 weeks following discharge with a complication rate of 3%. Microscopic examination of appendices removed at interval appendicectomy revealed that over one third of specimens showed evidence of acute or subacute inflammation. There were no deaths in this series. Our results show that conservative management of appendiceal masses is a safe and effective method of treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00183394
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